The Prognostic Nutritional Index as a predictor of in-hospital mortality in geriatric intensive care patients

Authors : Kübra Taşkın, Merve Bulun Yediyıldız, İrem Durmuş, Reyhan Fidan

Pages : 502-506

Doi:10.32322/jhsm.1666689

View : 79 | Download : 55

Publication Date : 2025-05-30

Article Type : Research Paper

Abstract :Aims: This study aimed to evaluate the prognostic value of the Prognostic Nutritional Index (PNI) in predicting in-hospital mortality among geriatric patients admitted to the intensive care unit (ICU). Methods: This single-center, retrospective cohort study included 337 patients aged ≥65 years who were admitted to the ICU between June and December 2024. Patients were divided into two groups based on clinical outcomes: survivors and non-survivors. Demographic data, comorbidities, clinical outcomes, and laboratory values including serum albumin and lymphocyte count were analyzed. PNI was calculated as: PNI=[10×serum albumin (g/dl)]+[0.005×total lymphocyte count (/mm3)]. Statistical analyses included univariate and multivariate logistic regression and receiver operating characteristic (ROC) curve analysis. Results: Among 337 patients, 195 (57.9%) died during ICU stay. PNI scores were significantly lower in non-survivors (p=0.001), with an optimal cut-off value of ≤29.8 (sensitivity: 43.1%, specificity: 90.1%). The area under the ROC curve for PNI was 0.661, indicating limited discriminatory power. Multivariate analysis identified prolonged ICU stay (OR=1.052), elevated WBC (OR=1.044), hypoalbuminemia (OR=2.283), increased urea (OR=1.006), lactate (OR=1.144), sepsis (OR=2.362), and stroke (OR=2.746) as independent predictors of mortality (p<0.05). Conclusion: Low PNI scores are associated with in-hospital mortality in geriatric ICU patients. However, given its low sensitivity and moderate AUC, PNI should not be used as a standalone predictor. Instead, as a simple and cost-effective biomarker, it may serve as a supportive tool alongside other clinical parameters for early risk stratification in geriatric intensive care settings.
Keywords : Prognostik Beslenme İndeksi, malnütrisyon, geriatrik hasta, yoğun bakım ünitesi, mortalite, albümin, lenfosit sayısı

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